What are preeclampsia and eclampsia?
Preeclampsia can turn into eclampsia without proper monitoring and treatment.
Preeclampsia and eclampsia are pregnancy-related, high blood pressure disorders. Preeclampsia is a sudden spike in blood pressure, whereas eclampsia is a more severe case that can include seizures or coma. Preeclampsia can progress into eclampsia without proper monitoring and treatment.
Both of these conditions lie on the spectrum of high blood pressure, also known as hypertension, that can occur during pregnancy.
What is preeclampsia?
On the hypertension spectrum, gestational hypertension sits on the mild end. This occurs when a woman who typically has normal blood pressure develops high blood pressure at 20 weeks or more of pregnancy and returns to normal within 12 weeks. In most cases, this is not a threat to the mother or child.
It is considered preeclampsia, however, when you have severe gestational hypertension and have a preterm birth or an infant who is smaller. Blood pressure that reaches 140/90 mmHg during pregnancy is usually considered preeclampsia.
What is eclampsia?
Preeclampsia turns into eclampsia when the blood pressure rises even more, and you begin to have seizures or a stroke. Untreated eclampsia is life-threatening to the mother and baby.
Symptoms of preeclampsia and eclampsia
Mild preeclampsia might not show any symptoms or just some minor swelling of the hands or feet. Eclampsia is when preeclampsia symptoms become severe and life-threatening.
Symptoms of preeclampsia
Common symptoms of preeclampsia include:
- Abdominal Pain
- Headache
- Nausea
- Trouble breathing
- Visual changes
- Excess protein in urine
- Swelling in the legs
Symptoms of eclampsia
Severe preeclampsia can lead to muscle spasms or seizures. Most often, they are generalized seizures that cause you to lose consciousness and have jerking movements of the legs and arms. Loss of bowel control is also possible.
Causes of preeclampsia and eclampsia
The causes of preeclampsia and eclampsia are not known. These conditions were previously called toxemia, because it was believed to be caused by a toxin in the blood. Doctors and nurses sometimes still refer to these disorders as toxemia.
There is recent research, however, that is starting to provide some good clues. One hypothesis is that preeclampsia happens when the placenta does not anchor itself as deeply as expected within the uterus wall during the first trimester. It is not clear what causes this problem, but it may be influenced by the parents’ genes or pre-existing conditions in the mother such as diabetes or hypertension.
Preeclampsia is the leading cause of illness for mothers and fetuses. Doctors believe that the following conditions do increase the chance that a woman can develop preeclampsia:
- Age (being under 15 or over 35 years old)
- Diabetes
- Ethnicity (especially African-American or Hispanic)
- Female family member who’s had preeclampsia
- First pregnancy
- Having had preeclampsia in a previous pregnancy
- Kidney disease
- Obesity
- Pregnancies with multiple fetuses (i.e., twins or triplets)
Diagnosis of preeclampsia and eclampsia
It is important for women to see a doctor regularly during pregnancy in order to identify any early signs of preeclampsia and begin treatment. Your health care provider will measure your blood pressure and test your urine for protein levels. Abnormal levels of either or both of these measurements is a good indicator of preeclampsia.
There are several levels of preeclampsia that progress towards eclampsia:
Gestational hypertension
This will be diagnosed if you have high blood pressure but no protein in your urine. Additionally, this will be the diagnosis if you had normal blood pressure before becoming pregnant and have elevated levels after 20 weeks of pregnancy.
Mild preeclampsia
The doctor will determine you have mild preeclampsia if:
- Your systolic blood pressure number goes above 140 mmHg
- Your urine content has 0.3 or more grams of protein
- Your blood tests show kidney or liver dysfunction
- There is fluid in your lungs making breathing difficult
- You experience visual impairments
Severe preeclampsia
Severe preeclampsia is indicated by a systolic blood pressure above 160 mmHg or a diastolic blood pressure above 110 mmHg or higher. Additionally, if you have urine with 5 or more grams of protein in a 24-hour specimen or 3 or more grams in two samples collected four hours apart, severe stomach pain, and trouble seeing, you will be diagnosed with severe preeclampsia.
Eclampsia
A severe form of preeclampsia that includes seizures can occur before or during labor, and can even be experienced after the baby is delivered.
Treatment of preeclampsia and eclampsia
The ideal therapy for preeclampsia and eclampsia is to deliver the baby. Once the fetus and placenta are out, symptoms of preeclampsia tend to subside. Complications can still occur after birth, however, so caution and monitoring should also be taken postpartum.
Specific treatment depends on the severity of the preeclampsia. Mild symptoms will instruct your doctor to delay delivery until the fetus is mature enough to live outside the womb. Severe symptoms will prompt preventive measures to protect the mother and fetus, like constant blood pressure monitoring and medication.
If the symptoms have progressed to eclampsia, early delivery of the baby may occur, as well as taking magnesium sulfate to prevent seizures.